By Steven Reidbord
KevinMD.org
Originally published May 1, 2014
Here are some excerpts:
A few years ago I wrote that uncertainty is inevitable in psychiatry. We literally don’t know the pathogenesis of any psychiatric disorder. Historically, when the etiology of abnormal behavior became known, the disease was no longer considered psychiatric. Thus, neurosyphilis and myxedema went to internal medicine; seizures, multiple sclerosis, Parkinson’s, and many other formerly psychiatric conditions went to neurology; brain tumors and hemorrhages went to neurosurgery; and so forth.
(cut)
Patients are told they suffer a “chemical imbalance” in the brain, when none has ever been shown. Rapid advances in brain imaging and genetics have yielded an avalanche of findings that may well bring us closer to understanding the causes of mental disorders. But they haven’t done so yet — a sad fact obscured by popular and professional rhetoric. In particular, functional brain imaging (e.g., fMRI) fascinates brain scientists and the public alike. We can now see, in dramatic three-dimensional colorful computer graphics, how different regions of the living brain “light up,” that is, vary in metabolic activity. Population studies reveal systematic differences in patients with specific psychiatric disorders as compared to normals. Don’t such images prove that psychiatric disorders are neurobiological brain diseases?
Note quite.
The entire article is here.
Thanks to Ed Zuckerman for this information.
Tuesday, May 20, 2014
Lady Gaga's foundation supports youth mental health discussions - all by text messaging
By Will Schutt
Medill Reports
Originally posted April 24, 2014
Texting offers new way to get youth engaged in mental health discussions. Creating Community Solutions and Lady Gaga's Born This Way Foundation are sponsoring a texting conversation about mental health. All you need to chime in is a cell phone. The latest digital mental health discussion for and between young people kicks off today.
An emerging mental health “conference” offers a new kind of group rapport: a conversation entirely conducted by texting.
(cut)
Occasionally, people text in who are in crisis. To make sure they get immediate assistance, one of the first texts people receive is the number for the national hotline for mental health crises.
The entire article is here.
Medill Reports
Originally posted April 24, 2014
Texting offers new way to get youth engaged in mental health discussions. Creating Community Solutions and Lady Gaga's Born This Way Foundation are sponsoring a texting conversation about mental health. All you need to chime in is a cell phone. The latest digital mental health discussion for and between young people kicks off today.
An emerging mental health “conference” offers a new kind of group rapport: a conversation entirely conducted by texting.
(cut)
Occasionally, people text in who are in crisis. To make sure they get immediate assistance, one of the first texts people receive is the number for the national hotline for mental health crises.
The entire article is here.
Monday, May 19, 2014
Moral luck, agent regret and the doctor as drug
By Jonathon Tomlinson
BMJ Blogs
Originally posted April 3, 2014
Here is an excerpt:
Professional identity is particularly strong in doctors and medical students, and perhaps more than our non-medical peers we assimilate this into our personal identity. With this, comes an enhanced sense of moral responsibility; we cannot avoid thinking that we are morally responsible for what happens to our patients.
This spectrum of moral responsibility is intrinsic to our underlying constitution and moral predispositions. The efforts of lawyers, ethicists and moral philosphers to impose definitions seem far removed from experiences like those described above and our self-imposed moral standards. It is not only our attachment to our professional identity, but the nature of our work that makes us vulnerable to moral luck and agent regret.
The entire article is here.
BMJ Blogs
Originally posted April 3, 2014
Here is an excerpt:
Professional identity is particularly strong in doctors and medical students, and perhaps more than our non-medical peers we assimilate this into our personal identity. With this, comes an enhanced sense of moral responsibility; we cannot avoid thinking that we are morally responsible for what happens to our patients.
This spectrum of moral responsibility is intrinsic to our underlying constitution and moral predispositions. The efforts of lawyers, ethicists and moral philosphers to impose definitions seem far removed from experiences like those described above and our self-imposed moral standards. It is not only our attachment to our professional identity, but the nature of our work that makes us vulnerable to moral luck and agent regret.
The entire article is here.
Very overweight teens face stigma, discrimination, and isolation
From a synopsis in the British Medical Journal
Here is an excerpt of the synopsis of the article:
In general, young people thought that individuals were responsible for their own body size. They associated excess weight with negative stereotypes of laziness, greed, and a lack of control. And they felt that being overweight made an individual less attractive and opened them up to bullying and teasing.
Young people who were already overweight tended to blame themselves for their size. And those who were classified as very overweight said they had been bullied and physically and verbally assaulted, particularly at school. They endured beatings, kickings, name-calling, deliberate and prolonged isolation by peers, and sniggering/whispering.
Some young people described coping strategies, such as seeking out support from others. But the experiences of being overweight included feeling excluded, ashamed, marked out as different, isolated, ridiculed and ritually humiliated. Everyday activities, such as shopping and socialising, were difficult.
The entire synopsis is here.
A link to the study is here.
Here is an excerpt of the synopsis of the article:
In general, young people thought that individuals were responsible for their own body size. They associated excess weight with negative stereotypes of laziness, greed, and a lack of control. And they felt that being overweight made an individual less attractive and opened them up to bullying and teasing.
Young people who were already overweight tended to blame themselves for their size. And those who were classified as very overweight said they had been bullied and physically and verbally assaulted, particularly at school. They endured beatings, kickings, name-calling, deliberate and prolonged isolation by peers, and sniggering/whispering.
Some young people described coping strategies, such as seeking out support from others. But the experiences of being overweight included feeling excluded, ashamed, marked out as different, isolated, ridiculed and ritually humiliated. Everyday activities, such as shopping and socialising, were difficult.
The entire synopsis is here.
A link to the study is here.
Sunday, May 18, 2014
Many Ivy League students don't view ADHD medication misuse as cheating: 18 percent use stimulants to help them study
By Science Daily
Source: American Academy of Pediatrics
Originally published May 1, 2014
Summary
Nearly one in five students at an Ivy League college reported misusing a prescription stimulant while studying, and one-third of students did not view such misuse as cheating, according to a new study. Stimulants are used to treat attention-deficit/hyperactivity disorder (ADHD). Recent studies have shown that students without ADHD are misusing these medications in hopes of gaining an academic edge.
The entire article is here.
Source: American Academy of Pediatrics
Originally published May 1, 2014
Summary
Nearly one in five students at an Ivy League college reported misusing a prescription stimulant while studying, and one-third of students did not view such misuse as cheating, according to a new study. Stimulants are used to treat attention-deficit/hyperactivity disorder (ADHD). Recent studies have shown that students without ADHD are misusing these medications in hopes of gaining an academic edge.
The entire article is here.
Saturday, May 17, 2014
U.S. Should Significantly Reduce Rate of Incarceration
Unprecedented Rise in Prison Population ‘Not Serving the Country Well,’ Says New Report
Press Release from the National Academy of Sciences
Released April 30, 2014
Given the minimal impact of long prison sentences on crime prevention and the negative social consequences and burdensome financial costs of U.S. incarceration rates, which have more than quadrupled in the last four decades, the nation should revise current criminal justice policies to significantly reduce imprisonment rates, says a new report from the National Research Council.
A comprehensive review of data led the committee that wrote the report to conclude that the costs of the current rate of incarceration outweigh the benefits. The committee recommended that federal and state policymakers re-examine policies requiring mandatory and long sentences, as well as take steps to improve prison conditions and to reduce unnecessary harm to the families and communities of those incarcerated. In addition, it recommended a reconsideration of drug crime policy, given the apparently low effectiveness of a heightened enforcement strategy that resulted in a tenfold increase in the incarceration rate for drug offenses from 1980 to 2010 — twice the rate for other crimes.
“We are concerned that the United States is past the point where the number of people in prison can be justified by social benefits,” said committee chair Jeremy Travis, president of John Jay College of Criminal Justice in New York City. “We need to embark on a national conversation to rethink the role of prison in society. A criminal justice system that makes less use of incarceration can better achieve its aims than a harsher, more punitive system. There are common-sense, practical steps we can take to move in this direction.”
The rest of the press release is here.
Press Release from the National Academy of Sciences
Released April 30, 2014
Given the minimal impact of long prison sentences on crime prevention and the negative social consequences and burdensome financial costs of U.S. incarceration rates, which have more than quadrupled in the last four decades, the nation should revise current criminal justice policies to significantly reduce imprisonment rates, says a new report from the National Research Council.
A comprehensive review of data led the committee that wrote the report to conclude that the costs of the current rate of incarceration outweigh the benefits. The committee recommended that federal and state policymakers re-examine policies requiring mandatory and long sentences, as well as take steps to improve prison conditions and to reduce unnecessary harm to the families and communities of those incarcerated. In addition, it recommended a reconsideration of drug crime policy, given the apparently low effectiveness of a heightened enforcement strategy that resulted in a tenfold increase in the incarceration rate for drug offenses from 1980 to 2010 — twice the rate for other crimes.
“We are concerned that the United States is past the point where the number of people in prison can be justified by social benefits,” said committee chair Jeremy Travis, president of John Jay College of Criminal Justice in New York City. “We need to embark on a national conversation to rethink the role of prison in society. A criminal justice system that makes less use of incarceration can better achieve its aims than a harsher, more punitive system. There are common-sense, practical steps we can take to move in this direction.”
The rest of the press release is here.
Friday, May 16, 2014
How Chicago is using psychotherapy to fight crime — and winning
By Dylan Matthews
Vox
Originally published May 1, 2014
The basics
The program in question is called Becoming a Man (BAM), and was developed by the nonprofits Youth Guidance and World Sport Chicago for use in Chicago schools. BAM consists of weekly hour-long sessions with groups of no more than 15 high school boys (the average instructor-student ratio is 1 to 8). It's not therapy in the strictest of senses, but the overall approach is borrowed from cognitive-behavioral therapy (CBT), which has overtaken more Freudian approaches in recent decades among practitioners and has a large research base demonstrating its effectiveness:
CBT is all about teaching meta-cognition: thinking about thinking. In a pure therapy setting, that means teaching patients to identify thought patterns that contribute to depression, anxiety, and so forth, so that they can work to replace them with healthier patterns. For example, a common negative thought pattern is catastrophizing, or exaggerating the importance of a short-term negative event in a way that causes undue distress and overreaction; if you've ever gotten a small piece of negative feedback from your boss and within a few minutes started worrying that you're about to get fired, that's catastrophizing in action.
The entire article is here.
Vox
Originally published May 1, 2014
The basics
The program in question is called Becoming a Man (BAM), and was developed by the nonprofits Youth Guidance and World Sport Chicago for use in Chicago schools. BAM consists of weekly hour-long sessions with groups of no more than 15 high school boys (the average instructor-student ratio is 1 to 8). It's not therapy in the strictest of senses, but the overall approach is borrowed from cognitive-behavioral therapy (CBT), which has overtaken more Freudian approaches in recent decades among practitioners and has a large research base demonstrating its effectiveness:
CBT is all about teaching meta-cognition: thinking about thinking. In a pure therapy setting, that means teaching patients to identify thought patterns that contribute to depression, anxiety, and so forth, so that they can work to replace them with healthier patterns. For example, a common negative thought pattern is catastrophizing, or exaggerating the importance of a short-term negative event in a way that causes undue distress and overreaction; if you've ever gotten a small piece of negative feedback from your boss and within a few minutes started worrying that you're about to get fired, that's catastrophizing in action.
The entire article is here.
Blaming the Kids: Children’s Agency and Diminished Responsibility
By Michael Tiboris
Journal of Applied Philosophy,Vol. 31, No. 1, 2014
doi: 10.1111/japp.12046
Abstract
Children are less blameworthy for their beliefs and actions because they are young. But the relationship between development and responsibility is complex. What exactly grounds the excuses we rightly give to young agents? This article presents three distinct arguments for children's diminished responsibility. Drawing on significant resources from developmental psychology, it rejects views which base the normative adult/child distinction on children's inability to participate in certain kinds of moral communication or to form principled self-conceptions which guide their actions. The article then argues that children's responsibility ought to be diminished because (and to the degree that) they are less competent at using features of their moral agency to meet social demands. This ‘normative competence’ view is philosophically defensible, supported by research in developmental psychology, and provides us with a method to evaluate whether things like peer pressure are relevant to responsibility.
The entire article is here.
Journal of Applied Philosophy,Vol. 31, No. 1, 2014
doi: 10.1111/japp.12046
Abstract
Children are less blameworthy for their beliefs and actions because they are young. But the relationship between development and responsibility is complex. What exactly grounds the excuses we rightly give to young agents? This article presents three distinct arguments for children's diminished responsibility. Drawing on significant resources from developmental psychology, it rejects views which base the normative adult/child distinction on children's inability to participate in certain kinds of moral communication or to form principled self-conceptions which guide their actions. The article then argues that children's responsibility ought to be diminished because (and to the degree that) they are less competent at using features of their moral agency to meet social demands. This ‘normative competence’ view is philosophically defensible, supported by research in developmental psychology, and provides us with a method to evaluate whether things like peer pressure are relevant to responsibility.
The entire article is here.
Thursday, May 15, 2014
Erotic Feelings Toward the Therapist: A Relational Perspective
By Jenny H. Lotterman
Journal of Clinical Psychology
Volume 70, Issue 2, pages 135–146, February 2014
Abstract
This article focuses on the relational treatment of a male patient presenting with sexual and erotic feelings toward the therapist. The use of relational psychotherapy allowed us to collaborate in viewing our therapeutic relationship as a microcosm of other relationships throughout the patient's life. In this way, the patient came to understand his fears of being close to women, his discomfort with his sexuality, and how these feelings impacted his ongoing romantic and sexual experiences. Use of the therapist's reactions to the patient, including conscious and unconscious feelings and behaviors, aided in the conceptualization of this case. Working under a relational model was especially helpful when ruptures occurred, allowing the patient and therapist to address these moments and move toward repair. The patient was successful in making use of his sexual feelings to understand his feelings and behaviors across contexts.
The entire article is here.
Editor's Note: Psychologists do not talk enough about erotic transference and countertransference in psychotherapy. These emotions happen more frequently than psychologists are willing to admit.
Journal of Clinical Psychology
Volume 70, Issue 2, pages 135–146, February 2014
Abstract
This article focuses on the relational treatment of a male patient presenting with sexual and erotic feelings toward the therapist. The use of relational psychotherapy allowed us to collaborate in viewing our therapeutic relationship as a microcosm of other relationships throughout the patient's life. In this way, the patient came to understand his fears of being close to women, his discomfort with his sexuality, and how these feelings impacted his ongoing romantic and sexual experiences. Use of the therapist's reactions to the patient, including conscious and unconscious feelings and behaviors, aided in the conceptualization of this case. Working under a relational model was especially helpful when ruptures occurred, allowing the patient and therapist to address these moments and move toward repair. The patient was successful in making use of his sexual feelings to understand his feelings and behaviors across contexts.
The entire article is here.
Editor's Note: Psychologists do not talk enough about erotic transference and countertransference in psychotherapy. These emotions happen more frequently than psychologists are willing to admit.
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